Medical Confidentiality v. Family Obligation

The above case regarding my sister’s husband, who tested positive for HIV/AIDS, is an incredibly challenging one. Overall, my personal interest conflicts with the professional obligations I have to both the patient and the clinic. Because of this conflict, there would be a challenge for me to take on the case myself. Personally, I feel obligated to tell my sister about her risk for HIV. To be aware of this information and not be able to say something is a difficult moral dilemma, given my professional connections to the case. Professionally, however, I have a responsibility to my sister’s husband as a client to the clinic. Because of HIPAA, I am obligated by a code of physicians' ethics to respect his confidentiality, noting that “the federal Health Insurance Portability and Accountability Act (HIPAA) affects confidentiality in all aspects of patient care (Brooke 2004, p. 23). Since this confidentiality includes his spouse and family members, I have to respect his privacy and keep the information secret, in spite of my personal connections to the case.

On the other hand, there are two people who I can claim to owe a duty of care due outside of the patient: my sister and her unborn child. If my sister were to test positive for HIV, then there is a strong possibility that the child will be born with it as well. This duty of care was addressed in the 1999 case in Sydney, Australia of BT v. Oei. Aside from the negligence that the defendant was found guilty for, it was concluded that “medical practitioners have a common law duty of care to the sexual partners of a person who may reasonably be suspected of being HIV positive (Mair 2008, p. 54). Unfortunately, because this common law is specific for Australia, it cannot justify my sharing information with my sister but does add some moral justification for how I work with the patient in confidentiality.

Therefore, the most logical option I have would be to recommend counseling for my sister’s husband as a patient. With this, I would strongly urge him to share with my sister as his sexual partner, so that she can get tested and prepare for the baby’s possible risk.  

References

Mair, J. (2008). Duty of confidentiality and HIV/AIDS. Health Information Management Journal, 37(3), 50-54.

Brooke, P. (2004). Deadly secrets. Nursing, 34(7), 23.